Coming back from the imperial capital, Yang Ping brought Xiao Su some special snacks from the imperial capital, as well as some handicraft gadgets that girls like, such as hairpin bracelets and the like, all of which are beautiful cheap tricks, but Xiao Su likes them very much.

Every time Yang Ping goes out, as long as he goes out of the province, he will definitely bring small gifts to Xiao Su, and other things can be forgotten, and this matter will never be forgotten.

After coming back, Yang Ping will also share the surgery done outside with Xiao Su, and Xiao Su will listen to it with relish, and his eyes are full of admiration and admiration for Yang Ping.

When I came back, it was already noon, so Yang Ping went to the department after lunch.

The current state of the department is very good, Xia Shu has been fully integrated into the new team, and soon, Dr. Moon and Dr. Jin from the Department of Orthopaedics will be transferred to the Institute of Surgery, so that the Institute of Surgery will have two more doctors, and the staff will be more abundant than before.

Yang Ping went to surgery in the afternoon, did a few surgeries, and went to the general surgery department to visit Pan Doudou after work, she has not been discharged from the hospital, this little girl fortunately seized the opportunity of the live broadcast to earn some money, otherwise there would not be so much money to be hospitalized and waiting for an organ transplant.

The skinny Pan Doudou was lying on the hospital bed, with an infusion tube attached to the left subclavian area, and in order to use intravenous nutrition for a long time, the nurse had done a puncture and catheter for her subclavian vein.

Now she is completely dependent on intravenous nutrition to keep her alive, and even if she doesn't eat, the air build-up caused by her bowels that has lost her ability to move is enough to make her miserable.

The condition is getting more and more serious, and Pan Doudou's whole body presents a more serious skinny appearance, with the frontal bone, cheekbones and mandible all protruding, and the outlines of the bilateral eye sockets are faintly visible, making people look like they already have a terrifying feeling, rather than the so-called bony beauty.

Even in this state, Pan Doudou did not forget the live broadcast, her state aroused the sympathy of fans, and everyone spontaneously donated money to her, cheering her on, hoping that she could get through, people with fans are different.

After watching Pan Doudou, Yang Ping sat in the doctor's office of the Department of General Surgery for a while and chatted with Director Fang about Pan Doudou's condition.

"A few days ago, there was a patient who died in a car accident, and his family had agreed to donate his organs, but later he regretted it."

It is understandable that Chinese people are generally reluctant to donate their organs due to the influence of traditional beliefs.

Director Fang couldn't help but feel a little regretful, and at the same time apologized for calling Yang Ping in the middle of the night, he was really excited that day, and he didn't figure out the situation for a while, so he called Yang Ping's phone directly.

As a doctor, who cares about answering the phone in the middle of the night, sometimes the mobile phone is very quiet on vacation, and I am not used to it.

In the past, when Yang Ping was the general hospital, the mobile phone assigned by the department to the general hospital was a Nokia old man's machine, and that kind of ringtone is still engraved in Yang Ping's brain.

"This kind of thing can only wait, contact me if necessary." Yang Ping can't help it, and the matter of waiting for organs can only be fate.

"Her CA199 is very high, almost 10 times higher." Dr. Chan in charge of the bed reported.

"yes, we're looking into why." Director Fang's face showed a slight look of worry.

"I remember that she had done CA199 before, is it normal?" Yang Ping asked.

Dr. Chen nodded: "Yes, I have done CA199 before, and it has always been normal. ”

CA199 is a tumor marker, so high, it is more than 10 times, if the tumor is considered, then the previous diagnosis may be overturned, and before the organ transplant, the diagnosis is not problematic.

Tumor markers are only an indicator, not necessarily a tumor, but other factors need to be considered.

Pan Doudou's current diagnosis is autoimmune intestinal leiomyositis, Yang Ping has personally seen the pathological section, this will definitely not be a problem, is there a tumor in other parts, Yang Ping began to investigate in his brain.

"Bring me the medical records and I'll take a look." Yang Ping felt that he should take a good look at the medical records again.

Dr. Chen immediately took the medical records, but the few checklists he checked recently were not added and were still placed in the cabinet of the nurse's station. ”

A trainee immediately ran to get the checklist, and he was so anxious that sweat broke out on his forehead, and these checklists were all tests that were added after the CA199 elevated.

"Take out all the check-ups before she was admitted to the hospital, how can it be like squeezing toothpaste." Director Fang reprimanded his graduate students and trainees.

Yang Ping flipped to this checklist, CA199 actually has 255U/ml, and the general normal value is 0-25U/ml, that is, it has reached more than 10 times the normal high value. Generally speaking, this index is more common in pancreatic cancer, liver cancer, colon cancer, and some benign tumors of the digestive system will also be elevated.

However, the specificity of this index is insufficient, and there are two important evaluation parameters for all clinical tests: sensitivity and specificity.

sensitivity to detect the presence of disease; Specificity reduces the chance of error.

The so-called high sensitivity is the ability to detect diseases is very strong, if you use antivirus software to detect viruses as an analogy, 10,000 files mixed with 100 viruses, it can detect all 100 of them, but unfortunately, it detects that it is not only 100 files that are considered to be viruses, there are hundreds, and 100 viruses are included in these hundreds of files.

What is specificity, specificity is that it can only detect 50 viruses, but these 50 are all viruses, and there are no other files mixed in.

CA199 is not very specific, and even if it is elevated, it is not necessarily pancreatic cancer.

For example, during a woman's menstrual period, CA199 will rise, Yang Ping thought about it, and there is no sign of tumor in this other examination, which should be due to other reasons.

"What is the patient's menstrual regularity? Is it a period now? ”

"Well, Dr. Chen didn't pay much attention to the patient's menstrual regularity." Dr. Li couldn't answer for a while, so he looked through the medical records, and there was a column in the hospitalization record that specifically recorded the menstrual history, but many doctors may not pay much attention to it.

Seeing the menstrual history recorded at that time, Dr. Tan began to calculate the date of the next menstrual period.

"Just ask, what's wrong with your fingers here." Director Fang is a knife-mouthed tofu-hearted person with a straightforward personality, so he likes to train people a little.

However, the doctors under him are used to it, and he trains people and trains people, but he has no bad intentions, but he is very protective of the doctors under him.

Dr. Chen immediately ran to the ward to ask Pan Doudou about his menstrual history, and after asking, he came back and said, "I did come, and it is the second day, but the amount is very small." ”

''Her current nutritional state, menstrual flow must be scarce, and some patients will also have amenorrhea in this nutritional state. Yang Ping judged.

If so, then the increase in the index of CA199 should be a reaction to menstruation, not an increase caused by some tumor, and it will have no effect on future surgeries, so Yang Ping can rest assured.

Coming out of the surgical building, just at the gate of the Institute of Surgery, Yang Ping met the head nurse Cai, the head nurse sprained her foot and put on a plaster, but she was a workaholic and unwilling to take a vacation, so she went to work on crutches, but it was inconvenient to commute with crutches, and the doctors and nurses in the department were very busy, and no one wanted to help, only Xia Shu, who was new here, and there were not so many things.

The head nurse lives in a community near the hospital, so Xia Shu uses a wheelchair to push her to commute every day.

Song Zimo and Xu Zhiliang in the department have seen the head nurse's injury, and they said that the injury is indeed very serious, but the plaster cast can be worn for a few days, and the key crutches can last for a month, and the complete recovery will take almost three months.

If it weren't for the head nurse's usual physique, the ankle joint would definitely be very swollen, but now the swelling is not very obvious.

The head nurse is very anxious, what can I do, the department is so busy now, it is unlikely that a vacation is possible.

At that time, Yang Ping went to the imperial capital, and Song Zimo, who was guarding the house, was the acting director of the department, he said that it was not appropriate to take a vacation at this time, and hoped that the head nurse could focus on the overall situation and insist on going to work while sick, but he must send a person to pick up and drop off the head nurse for commuting.

Song Zimo asked around, hoping to find a nurse to perform such a difficult task, but the nurses shook their heads, and they couldn't spare time.

There was no way, Song Zimo had no choice but to say to Xia Shu: "Doctor Xia, this matter can only trouble you, rest assured, the department will remember your contribution." ”

Xia Shu said that this matter is easy, not to talk about any contribution or contribution, with a gesture, the head nurse lives opposite, and it is inconvenient to drive, as long as there is a wheelchair, he pushes the head nurse to and from work every day.

Song Zimo patted Xia Shu on the shoulder: "Doctor Xia, you are still highly conscious, I thank you on behalf of the department." ”

In this way, Xia Shu began to use a wheelchair to push the head nurse to commute every day, and the wheelchair that had just been pushed out of the ward was a little bad, Xia Shu wanted to change to a wheelchair, so he asked the outpatient nurse to get a new wheelchair.

Yang Ping chatted with the head nurse, Xia Shu had already pushed out the wheelchair from the outpatient clinic on the first floor, and he immediately greeted Yang Ping when he saw him: "The professor hasn't gotten off work yet?" ”

''I just went to the general surgery department to see a patient, and now I go back to the department to put my clothes off work. Yang Ping said.

Xia Shu was quite careful, carefully helped the head nurse to sit in the wheelchair, and then said goodbye to Yang Ping, and pushed the wheelchair very hard to the head nurse's house across the street.

Sometimes it's really strange, usually the head nurse is the kind of royal sister who is full of workplace temperament, but now she just sprains her ankle, how can she be like a little girl.

——

Back in the office of the department, Yang Ping rested for a while, and he entered the system space laboratory to take a look.

Experiments in the system space are still ongoing, and they are not the same as before since the system rules were upgraded.

According to the previous rules, Yang Ping came out of the system space, and everything in the system space stopped at that moment, and after Yang Ping entered the space again, the system space would start again from the moment it stopped.

Now it is different, even if Yang Ping is out of the system space, the experiment will continue, and the time schedule inside will advance proportionally, much faster than the real time.

In this way, the experiment of the system space can be carried out in parallel with Yang Ping's real activities, which has advantages and disadvantages, the advantage is that the two are not delayed, and the disadvantage is that once Yang Ping leaves, if the experiment in it goes wrong, it will continue to be wrong, in short, each has its own advantages and disadvantages.

This time, Yang Ping entered the system space and found that there was a cell bank that used tumor cells as the culture object, and the vast majority of cells had died.

This cell bank was established by Yang Ping with great painstaking efforts, and has been used to observe the performance of tumor cells in the process of division, but he didn't expect to die so much without paying attention to it.

It's like a farmer who worked hard to make a fortune from two pigs, turning the number of pigs on the farm into hundreds and thousands, but suddenly one day, a swine fever made the pig farm lie a large number of dead pigs.

Fortunately, just in case, Yang Ping also kept some seed cells, which were taken from Sisi's body at that time, and all the tumor cells used in the laboratory were derived from Sisi's body.

It was just an accident, Yang Ping fell into deep thought at the cell, and suddenly a flash of inspiration flashed in his mind.

These are tumor cells, and most of them die suddenly, which is a blow to their stem cell experiments, but isn't it a good thing for tumor research?

Isn't the ultimate goal of any cancer study to kill tumor cells? Thinking of this, Yang Ping immediately had a new idea in his mind.

These dead tumor cells are not waste garbage, but treasures, and it is time to set up a new project to study the causes of death of these cells, and maybe find some new ways to treat tumors.

In fact, in the field of medicine, it is very difficult to study a certain mechanism clearly, as long as you can really study one, it is enough to hit the Nobel Prize.

One of the Nobel Prize winners in physiology or medicine was to study why peppers are spicy and why are peppers spicy? This is something that everyone understands, but the mechanism and why it is the way it is difficult to figure out from a scientific point of view.

Two American scientists won the Nobel Prize for their research on eating chili peppers to feel spicy, and the foodies who taste various flavors every day don't crowd the Nobel podium?

In fact, it is easier said than done.

These two scientists are from a deep, very deep level, from the molecular level deeper than the cell, to reveal why eating chili peppers will make the mouth and chrysanthemum spicy, this is not only a problem of spicy, but also a problem of pain, they clearly explain why people have pain from the molecular level, so as to reveal the mechanism of human pain transmission from the molecular level, so as to win the Nobel Prize.

The death of cells seems to be a simple matter, but rising to the level of such a serious science is by no means as simple as imagined.

First of all, cell death can be divided into two categories, regulatory death and accidental death, which is similar to natural death and accidental death of humans, and these two ways of death add up to 11 ways, some of these 11 ways of death have Chinese translation, such as apoptosis, ferroptosis, oxygen death, and some do not even have a Chinese translation, can only use English terms.

To study the cause of death of these tumor cells, you must first figure out what kind of cause of death they are, and then you have to figure out the cause of their death at the molecular level, the process, etc., which is not enough, you have to explain these in scientific language.

Yang Ping thinks that waste utilization has set up a new topic in the system space to study the death mechanism of these cells.